Cruzan's Legacy in Autonomy

Abstract

This Article identifies three situations in which end-of-life decision-making autonomy faces legal development unimaginable at the time of Cruzan v. Director, Missouri Department of Health, nearly thirty years ago. Legislatures and courts have been and increasingly will be grappling with the definition of autonomy in instances of voluntarily stopping eating and drinking, refusals of life-sustaining treatment by patients in the minimally conscious state, and objections to declarations of brain death.

Since Cruzan, the Supreme Court has adopted two versions of constitutionally protected decision-making, both of which have roots in the opinions in that case. As clinical progress continues, we will see the law of medical end-of-life decision-making autonomy repeatedly invoke Cruzan in a broader range of settings. Ms. Cruzan's legacy lives on.

Keywords: end-of-life, life-sustaining treatment, autonomy, decision-making

JEL Classification: I1, I19